High impact
Hip Preservation Surgery (CPB 0736, reviewed 2026-07-31)
Aetna·Effective Jul 31, 2026
Aetna has updated its Hip Preservation Surgery policy (CPB 0736) effective 2026-07-31, establishing strict medical necessity criteria for femoro-acetabular surgery, hip arthroscopy, and pelvic osteotomy. The policy requires documented labral pathology with imaging confirmation, 12 weeks of conservative treatment (including 6+ weeks formal in-person physical therapy), positive impingement signs, and absence of advanced osteoarthritis before surgery is covered. Multiple procedures including diagnostic hip arthroscopy, labral reconstruction, and various adjunctive procedures are classified as experimental/unproven and will not be covered.